Gastric bypass surgery can provide a long-term weight loss. For most people, they lose about 10 to 20 pounds each month within the first year after surgery. Over time, the weight loss continues. More weight is expected to be lost when the patient seriously commits to the diet and exercise since the start of the treatment.
Recovery After Gastric Bypass Surgery
The recovery period will depend on the size of the incision made during surgery. For a laparoscopic gastric bypass surgery, the usual hospital stay would likely be from two to three days. For an open surgery, where a bigger incision was made, the patient’s recovery and stay in the hospital would be much longer.
Prior to discharge, the surgeon must be able to ensure that the wounds are healing properly, the patient is able to pass gas, and there are no leaks on the staple line. Moreover, the patient, including family members, will be educated regarding the warning signs that they should be aware of. These signs include fever, signs of infection in the incised area (pus, heat, swelling, and redness), ongoing vomiting or nausea, worsening pain, and difficulty in swallowing. If any of these signs happen, contacting the surgeon must be made right away.
Recovering at Home
Pain or soreness is common after undergoing a gastric bypass surgery. Take the pain medication prescribed by the doctor accordingly. However, pain medications may cause constipation. Dealing with constipation during the first few weeks post surgery must be included in the discharge instructions. The medications may be adjusted until the patient is fully healed.
Walking whenever possible is highly advised, however, it must not be done too much because the patient will still feel weak after surgery. Rest and sleep are also necessary to be able to help the body heal faster. Resting at a slight incline or having extra pillows can ease some of the pain in the abdomen as well as decrease the risk of heartburn.
Dehydration becomes a risk after a gastric bypass surgery. Thus, drinking an adequate amount of water is necessary. Food can also provide a fair amount of water. However, since the patient is still recovering from the surgery, restrictions on food could still be applied. When drinking water, do not use a straw because it would be easy for the patient to quickly drink too much. Remember that the patient is at risk of swallowing unnecessary air that can put too much pressure on the new stomach.
Coughing is usually encouraged in patients who had a gastric bypass surgery as it helps expand their lungs and bring up any fluids that could remain after surgery. However, coughing is painful after the surgery. Therefore, it is recommended to use a cough pillow. The cough pillow prevents large movements in the abdomen. It also helps by reducing the intensity of pain.
Most of the time, the patient is advised to wait until the first follow-up surgeon’s appointment before he or she can take a shower or bath. It is important that the incisions stay clean and have enough time to heal. The patient must not lift anything that is over 15 pounds for a period of six to seven weeks.
The new stomach is going to be sensitive, especially in the beginning. Thus, the patient will be on a liquid diet for a few weeks before gradually transitioning to solid foods. Since the patient is eating less, the patient may feel lethargic and tired until the body adjusts.
After surgery, a strict diet should be followed for various reasons. First, the stomach is much smaller and it is still recovering from the surgery. Second, the intestines have been incised and re-routed. Lastly, there are still staples that hold the tissues together. Therefore, it is very important not to place too much stress on the tissues since they are still in the process of healing.
The risk of having a staple line leak is possible if the patient consumes fibrous food, large meals, and carbonated beverages.
First Week Diet: Liquids
During the first week after surgery, certain liquids must be sipped gradually at the rate of 2 oz per hour. Most doctors and dieticians recommend water, sugar-free jello, fat-free broth, and fat-free milk.
Second to Third Week Diet: Pureed Foods
For the next week or two, the patient will be able to eat pureed foods throughout the day in small portions. At this stage of the diet, the patient must be able to focus on eating slowly. Moreover, during this stage, the recommended daily intake of protein is only 60 to 70 grams and 64 oz of liquid per day.
Each portion of pureed food must be consumed for a 30-minute period. This routine must remain as a goal all throughout the post-operative stages. Fat, caffeine, sugar, and carbonated beverages are to be avoided. Patients must wait at least 30 minutes before and after eating prior to drinking.
Fourth to Fifth Week Diet: Soft Foods
Over time, soft types of food will be added to the diet. During this phase of the diet, the patient will be able to eat some vegetables and lean meats that are soft enough to be easily crushed with a fork. A small amount of fat may also be allowed, depending on the doctor or dietician.
The recommended soft foods can include fish, tofu, canned tuna, shredded chicken, egg whites, fat-free cheese, and fat-free cottage cheese. Avocados, squash, steamed carrots, and mashed green beans are some of the recommended vegetables.
Sixth Week Diet: Solid Foods
The last phase of the diet plan is solid foods. The objective at this stage is to reintroduce healthy foods in little portions. Start by eating softer foods before slowly dealing with fibrous and chewy foods. The introduction of new foods must be done gradually because introducing new foods abruptly may cause heartburn, bloating, painful gas, and dumping syndrome. Thus, it is recommended to introduce one food at a time. If possible, wait at least one day before introducing a new type of food.
Patients must stay away from bread, refined sugar, rice, pasta, and chips, which are examples of junk carbohydrates. Vegetables must be the primary source of carbohydrate. Corn, beans, grapes, nuts, pork, beef, and shellfish are some of the foods that are difficult to process. Therefore, these foods must be added gradually and in small portions.
During the last phase, the patient must be able to lessen the meals per day into three small meals and supplemented with protein shakes. Sooner or later, the patient’s total caloric intake will reach 1,000 to 1,500 calories per day, however, do not push it.
Vitamins and Supplements
The new stomach limits the quantity of food to be eaten after a gastric bypass surgery. The bypassed intestines also reduce the absorption of vitamins and minerals. That is why some patients experience vitamin and mineral deficiencies after their surgery.
Therefore, it is important to take vitamins as well as supplements after surgery and for the rest of the patient’s life. Multivitamins, calcium citrate, vitamin D3, vitamin B12, zinc, folate, and iron are some of the essential and recommended supplements for patients who have undergone a gastric bypass surgery.